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Titre : | Home Health Agency Characteristics and Quality Outcomes for Medicare Beneficiaries With Rehabilitation-Sensitive Conditions (2018) |
Auteurs : | Tracy M. Mroz ; Ann Meadow ; Elizabeth Colantuoni |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 99, n° 6, 2018) |
Article en page(s) : | p. 1090-1098 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Qualité des soins de santé ; Recherche sur les services de santé ; Rééducation et réadaptation ; Services de soins à domicile |
Mots-clés: | Health services research ; Home care services ; Medicare ; Quality of Health Care |
Résumé : |
Objective To examine associations between organizational characteristics of home health agencies (eg, profit status, rehabilitation therapy staffing model, size, and rurality) and quality outcomes in Medicare beneficiaries with rehabilitation-sensitive conditions, conditions for which occupational, physical, and/or speech therapy have the potential to improve functioning, prevent or slow substantial decline in functioning, or increase ability to remain at home safely. Design Retrospective analysis. Setting Home health agencies. Participants Fee-for-service beneficiaries (N=1,006,562) admitted to 9250 Medicare-certified home health agencies in 2009. Interventions Not applicable. Main Outcome Measures Institutional admission during home health care, community discharge, and institutional admission within 30 days of discharge. Results Nonprofit (vs for-profit) home health agencies were more likely to discharge beneficiaries to the community (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.131.33) and less likely to have beneficiaries incur institutional admissions within 30 days of discharge (OR, .93; 95% CI, .88.97). Agencies in rural (vs urban) counties were less likely to discharge patients to the community (OR, .83; 95% CI, .77.90) and more likely to have beneficiaries incur institutional admissions during home health (OR, 1.24; 95% CI, 1.181.30) and within 30 days of discharge (OR, 1.15; 95% CI, 1.101.22). Agencies with contract (vs in-house) therapy staff were less likely to discharge beneficiaries to the community (OR, .79, 95% CI, .70.91) and more likely to have beneficiaries incur institutional admissions during home health (OR, 1.09; 95% CI, 1.031.15) and within 30 days of discharge (OR, 1.17; 95% CI, 1.071.28). Conclusions As payers continue to test and implement reimbursement mechanisms that seek to reward value over volume of services, greater attention should be paid to organizational factors that facilitate better coordinated, higher quality home health care for beneficiaries who may benefit from rehabilitation. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/archives-of-physical-medicine-and-rehabilitation |